| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W. ROSS3 Filed as: JOHN W ROSS | 214 E CENTER ST KINGSPORT, TN 37660 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 0.64% |
| HUGH G HINES3 | 121 E MAIN ST DANVILLE, KY 40422 | NORTHWESTERN MUTUAL | $4K | $963 | $5K | 0.56% |
| PROCTOR W BLAIR3 | 416 HIGH ST PARIS, KY 40361 | NORTHWESTERN MUTUAL | $3K | $688 | $4K | 0.40% |
| NM LOUISVILLE INC3 | 462 S 4TH ST STE 1900 LOUISVILLE, KY 40202 | NORTHWESTERN MUTUAL | $2K | $140 | $2K | 0.19% |
| CHARLES NATHANIEL JENKINS3 | 208 SUNSET DR STE 401 JOHNSON CITY, TN 37604 | NORTHWESTERN MUTUAL | $794 | $188 | $982 | 0.11% |
| CHARLES ROBERT PRUETT3 | 1600 DIVISION ST STE 400 NASHVILLE, TN 37203 | NORTHWESTERN MUTUAL | $695 | $61 | $756 | 0.08% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY RD, STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 1.95% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY RD, STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 1.44% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY RD, STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 1.81% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 1.86% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability(5 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 0 | $943K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.